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PubMedDate not supplied

[Child vaccination coverage in a rural community: prevalence and related factors].

In the rural environment investigations on vaccination coverage during the daily consultation of Primary Care is feasible. For knowing the real levels and improve the situation, infant vaccination coverage was studied in a rural township with hamlet (small villages) by interviewing the parents and checking the vaccination card. Demographics variables were also analysed looking for different coverage according to these characteristics. One hundred and five children from 0 to 14 years were studied. Relative risks were calculated for the situation of no vaccination. The 69% have got vaccination card. Vaccination rates for Tetanus, Oral Polio, Triple Virus (Measles, Rubella, Mumps) and Rubella (73.3%, 73.3%, 75.5% and 83.3% respectively) were not enough for its eradication. The older children and those who have the biggest family size, showed less rates. Those who live in hamlets have a greater risk to not to be vaccinate, being able to perform "bags" of the deficient vaccination. This survey has allowed to get a complete register of infant vaccination coverage and start correcting actions of the deficiencies noticed.

Adolescent↗
PubMed2003

Resolving functional diversity in relation to microbial community structure in soil: exploiting genomics and stable isotope probing.

The microbial ecology of soil still presents a challenge to microbiologists attempting to establish the ways in which bacteria and fungi actively metabolise substrates, link into food webs and recycle plant and animal remains and provide essential nutrients for plants. Extraction and in situ analysis of rRNA has enabled identification of active taxa, and detection of mRNA has provided an insight into the expression of key functional genes in soil. Recent advances in genomic analysis and stable isotope probing are the first steps in resolving the linkage between structure and function in microbial communities.

Bacteria↗
PubMed2001

Negative affect and interpersonal rejection among prison inmates in a therapeutic community: a social relations analysis.

The authors used D. A. Kenny's social relations model to examine J. C. Coyne's interpersonal theory of depression among a clinical sample of well-acquainted prison inmates. Members of 12 therapy groups (N = 142) diagnosed with a substance abuse disorder completed a self-report measure of depression and anxiety and indicated their desire to interact with other group members. There was both consensus about which group members were rejected and individual differences in the participants reported desire for future interaction with other group members. Those reporting high levels of depressive negative affect were most likely to be rejected. Those lowest in positive affect indicated the least desire for future interaction with others.

Adolescent↗
PubMed1995

Ehrlichiosis in a golf-oriented retirement community.

BACKGROUND: Ehrlichiosis due to Ehrlichia chaffeensis usually occurs sporadically or in small clusters, with an annual incidence estimated at 3 to 5 cases per 100,000 population in areas of endemic disease. The putative principal vector is the Lone Star tick (Amblyomma americanum). We investigated an outbreak of ehrlichiosis that occurred in June 1993 among members of a golf-oriented retirement community (community A) in Tennessee. The community is densely wooded and borders a wildlife-management area where deer are numerous. METHODS: We conducted a case-control study, using medical-history reviews, serologic testing, and testing with the polymerase chain reaction for E. chaffeensis infection. We also surveyed a sample of 10 percent of the households in community A and in another golf-oriented community (community B) more than 20 miles (32 km) from the wildlife-management area. Survey participants completed a questionnaire and provided specimens for serologic testing. In both communities, searches for ticks were undertaken. RESULTS: Eleven cases of symptomatic ehrlichiosis were identified in the case-control study, 10 of which were in community A (attack rate, 330 per 100,000). Of 311 surveyed residents of community A, 12.5 percent had serologic evidence of past E. chaffeensis infection, as compared with 3.3 percent of 92 in community B (relative risk in community A as compared with community B, 3.9; 95 percent confidence interval, 1.2 to 12.2). The risk of infection was associated with tick bites, exposure to wildlife, golfing, and among golfers, retrieving lost golf balls from the rough. Persons who never used insect repellent were more likely to have had infection than persons who did. In community A, thousands of Lone Star ticks were found; in community B, only three ticks were found. CONCLUSIONS: The high rate of E. chaffeensis infection in community A resulted from its proximity to a wildlife reserve. When outdoor recreational activities are common and concentrations of ticks are high, outbreaks of arthropod-borne zoonoses can be anticipated.

Adolescent↗
PubMedDate not supplied

Managing the nonsurgical candidate with an empyema related to community-acquired lobar pneumonia.

This case study reviews the medical management for a 76-year-old patient with a cardiac history and recurrent admissions for a persistent pneumonia. Computed tomography showed evidence of an empyema in the right middle and lower lobes of his lung. The standard treatment for an empyema is a thoracotomy and long-term antibiotics. However, the patient's cardiac history disqualified surgery as an option. Therefore the management plan was composed of antibiotics and treatment of his symptoms. The patient's symptoms improved after a week of levofloxacin (Levaquin), prednisone, bilevel positive airway pressure mask as required, and oxygen. He was discharged with home care, oxygen, Levaquin, tapering doses of prednisone, and previous medications. At a 6-week follow-up examination, the patient was asymptomatic and had marked improvement noted on chest radiograph. The advanced practice nurse played an important role in this patient's recovery by conducting patient education and coordinating follow-up after his release.

Aged↗
PubMed1991

The feasibility of conducting structured diagnostic interviews with preadolescents: a community field trial of the DISC.

A field trial of the Diagnostic Interview Schedule for Children, Version R, was conducted with a sample of 144 preadolescents identified from a 1986-1987 New Haven, Connecticut, cross-sectional children's mental health survey. This report examines procedural and methodological issues pertaining to the feasibility of completing structured diagnostic interviews with young children in the community. Four topics relating to community acceptance and potential response problems are addressed: 1) participation and completion rates; 2) quality of interview response; 3) parent and child reactions to the interview; and 4) evaluation of response bias.

Child↗
PubMed2005

Use of ribotyping to retrospectively identify methicillin-resistant Staphylococcus aureus isolates from phase 3 clinical trials for tigecycline that are genotypically related to community-associated isolates.

A retrospective study was performed to identify methicillin-resistant Staphylococcus aureus (MRSA) isolates obtained from patients enrolled in phase 3 clinical trials for tigecycline that were genotypically similar to known community-associated MRSA (CA-MRSA) strains. The clinical trials were double-blind comparator studies for complicated skin and skin structure infections or complicated intra-abdominal infections. We obtained 85% of the MRSA isolates from patients with complicated skin and skin structure infections. Using ribotyping, MRSA isolates were compared with well-characterized North American CA-MRSA strains and negative-control hospital-associated (HA) MRSA strains by cluster analysis; 91 of the 173 isolates clustered with two groups of known CA-MRSA strains, 60% of which shared an indistinguishable ribotype. These isolates were subsequently tested for the presence of SCCmec type IV and the Panton-Valentine leukocidin (PVL)-encoding genes as well as susceptibility to clindamycin, characteristics that are typically associated with CA-MRSA; 89 of the 91 isolates carried the type IV SCCmec element and 76 were also positive for the PVL-encoding genes; 73 of these isolates were susceptible to clindamycin. A similar analysis performed on 26 nonclustering isolates identified only four with these characteristics; 89 of the 91 clustering isolates were inhibited by tigecycline at MICs of < or = 0.5 microg/ml. On the basis of clustering information and preliminary genetic characterization, it appears that ribotyping is a useful tool in identifying potential CA-MRSA isolates and 76 MRSA isolates from patients enrolled in the tigecycline phase 3 trials have genetic markers typically associated with CA-MRSA.

Cluster Analysis↗
PubMed2001

The concept of priority as it relates to a community mental health team.

This article illustrates how a concept clarification exercise can provide evidence to inform local policy development. Based on the framework developed in Walker and Avant's (1995) concept clarification theory, the concept of priority is examined in the context of a team of community mental health nurses. Themes of risk, multidisciplinary working, resources, and nursing role are identified as key areas for consideration, and the difficulties existing between government policy directives towards the severely mentally ill and health promotion are discussed. The article highlights how nursing theory can integrate the concept analysis of priority in planning client care. This is presented using Peplau's (1952) model as a guide to further enhance meaning of generated priorities to nursing practice.

Community Health Nursing↗
PubMed1978

Hemodynamic monitoring in patients with hypotension after myocardial infarction. The role of the medical center in relation to the community hospital.

Patients who develop hypotension after acute myocardial infarction are frequently transferred to medical centers for hemodynamic monitoring. To see if this practice is justified, we reviewed our experience with hemodynamic monitoring over a two-year period. Of 40 patients who underwent hemodynamic monitoring for hypotension, 28 were transferred from other institutions. Eleven (39 percent) of these 28 patients had a pulmonary capillary wedge pressure of 16 mm Hg or less. Ten (91 percent) of these 11 survived, compared with one survivor (8 percent) in the 13 transferred patients with a pulmonary capillary wedge pressure of 17 mm Hg or more (P less than 0.001). The pulmonary capillary wedge pressure did not correlate well with the presence of a third heart sound on physical examination or with chest x-ray films. All hypotensive patients with a low pulmonary capillary wedge pressure received fluids to expand the blood volume as their major form of therapy. Thus, hemodynamic monitoring in patients with hypotension clarifies their status regarding blood volume and identifies those who will benefit from expansion of this volume. Transfer of hypotensive patients for hemodynamic monitoring seems justified, as their status regarding volume of blood is frequently difficult to ascertain by noninvasive means.

Adult↗